集束化护理干预在重型颅脑损伤后躁动患者中的临床应用效果  

Clinical value of bundle nursing intervention for patients with dysphoria induced by severe traumatic brain injury

作　　者：刘建荣[1] 王妮[2] 唐小璐[1] 曾娟[1] 潘亚英[1] 

机构地区：[1]西安医学院第二附属医院,西安710038 [2]西安交通大学第二附属医院,西安710061

出　　处：《广西医科大学学报》2017年第4期636-640,共5页Journal of Guangxi Medical University

基　　金：陕西省社会发展科技攻关项目(No.2015SF014)

摘　　要：目的:探讨集束化护理干预在重症颅脑损伤(sTBI)后躁动患者中的应用效果。方法:选取2014年8月至2016年5月本院收治的sTBI后躁动患者114例,按随机数字表法分为观察组与对照组,每组57例。对照组予以常规护理,观察组予以集束化护理,比较两组患者的护理效果。结果:观察组护理不良事件及并发症总发生率分别为1.75%、1.75%,显著低于对照组的14.04%、12.28%(均P<0.05)。观察组呼吸机使用时间、住ICU时间、总住院时间均显著短于对照组(均P<0.05);Ricker镇静—躁动评分(SAS)、美国国立卫生研究院卒中量表(NIHSS)评分及急性生理学及慢性健康状况(APACHEⅡ)评分均显著低于对照组,而格拉斯哥预后量表评分(GOS)显著高于对照组(均P<0.05);观察组护理总满意度为96.49%,显著高于对照组的82.46%(P<0.05)。结论:在sTBI后躁动管理中应用集束化护理干预能够显著减轻患者的躁动情绪,降低护理不良事件及并发症总发生率,促进患者神经功能康复,缩短住院时间并改善临床预后,护理满意度较高。Objective：To investigate the clinical value of bundle nursing intervention for patients with dysphoria induced by severe traumatic brain injury （sTBI）. Methods： A total of 114 patients with dysphoria induced by sTBI were randomly divided into an observation group and a control group, with 57 cases in each group. The patients in the control group received routine care, while those in the observation group received bundle nursing intervention. The nursing effects between the two groups were compared. Results： The incidence of adverse events and complications in observation group were both 1.75 %, which were significantly lower than those in the control group （14.04% and 12.28%, P 〈0.05）. The ventilation time, ICU hospitalization time and total hospital days in the observation group were significantly shorter than those in the control group （ P 〈0.05）. The Ricker sedation-agitation scale （SAS） scores, National Institute of Health Stroke Scale （NIHSS） scores and acute physiology and chronic health conditions （APACHE II） scores were significantly lower, while the Glasgow outcome scale （GOS） scores were significantly higher than those in the control group （ P 〈0.05）. The satisfaction rate of nursing care in the observation group was 96.49%, which was significantly higher than that in the control group （82.46%） （ P 〈0.05）. Conclusion： Bundle nursing intervention could effectively eliminate dysphoria, reduce the incidence of nursing adverse events and complications, promote neurological rehabilitation, shorten hospitalization time, improve clinical outcomes and elevate nursing satisfaction in sTBI patients.

关 键 词：重症颅脑损伤 躁动 集束化护理 护理不良事件 并发症 满意度 

分 类 号：R473.6[医药卫生—护理学]